SCHEDULE 1 Regulation 2(2)(a) Application Form Form CA16
Application Form for deposits under section 31(6) of the Highways Act 1980 and section lSA(l) of the Commons Act 2006
PART A: Information relating to the applicant and land to which the application relates (all applicants must complete this Part)
1. Name of appropriate authority to which the application is addressed: Bracknell Forest Council
2. Name and full address (including postcode) of applicant: Mr Andrew Hartley Veris Secretarial Services P0Box237 Peregrine House Peel Road Douglas Isle of Man IM991SU
Mrs Janet Hazel McGowan Balladoole House Castletown Isle of Man IM9 4PE
3. Status of applicant (tick relevant box or boxes):
Weare (a) D the owners ofthe land(s) described in paragraph 4. (b) liZ(making this application and the statements/deciarations it contains on behalf of White Knowle Ltd who is the owner ofthe land described in paragraph 4 and in our capacity as directors.
4. Insert description ofthe land(s) to which the application relates (including full address and postcode): Address: Billingbear Farm, Billingbear House, Bracknell, Berkshire RG42 5PL. The land is North West ofBinfield and lies in the Parish of Binfield.
5. Ordnance Survey six-figure grid reference(s) of a point within the area of land(s) to which the application relates (if known): ·
6. This deposit comprises the following statement(s) and/or declarations Parts B PART B: Statement under section 31(6) of the Highways Act 1980
1. We, J McGowan and A Hartley are the directors for the owner ofthe land described in paragraph 4 of Part A ofthis form and shown outlined red on the map accompanying this statement.
Ways shown brown on the accompanying map are byways open to all traffic- of which there are none Ways shown blue on the accompanying map are restricted byways - of which there are none Ways shown purple on the accompanying map are public bridleways - of which there are none Ways shown green on the accompanying map are public footpaths
2. No other ways over the land shown outlined red on the accompanying map have been dedicated as highways. PART F: Statement of Truth (all applicants must complete this Part)
WARNING: Ifyou dishonestly enter information or make a statement that you know is, or might be, untrue or misleading, and intend by doing so to make a gain for yourself or another person, or to cause loss or the risk of loss to another person, you may commit the offence offraud under section 1 of the Fraud Act 2006, the maximum penalty for which is 10 years' imprisonment or an unlimited lme, or both.
I BELIEVE THAT THE FACTS AND MATTERS CONTAINED IN TIDS FORM ARE TRUE
Signature (of the person making the statement of truth):
Print full name: Mr Andrew Hartley
Date: OrCJ Ju~ ?ol Signature (of the person making the statement of truth): I Print full name: Mrs Janet Hazel McG~wan (_iJ>~ - wri 1% ".v""U i.;t1)) Date: You should keep a copy of the completed form Data Protection Act 1998 - Fair Processing Notice The purpose of this Fair Processing Notice is to inform you ofthe use that will be made ofyour personal data, as required by the Data Protection Actl998. The appropriate authority (see explanation ofdefinition in above guidance notes) in England is the data controller in respect ofany personal data that you provide when you complete this form. The information that you provide will be used by the appropriate authority in its duties to process applications to deposit statements, maps and declarations under section 31 ( 6) the Highways Act 1980 and statements under section 15A(l) of the Commons Act 2006. The information you provide will also be used by the appropriate authority in its duty to update the registers in which details ofsuch deposits are recorded under the Dedicated Highways (Registers under Section 3 lA of the Highways Act 1980) (England) Regulations 2007 and the Commons (Registration ofTown or Village Gre~ns) and Dedicated Highways (Landowner Statements and Declarations) (England) Regulations 2013. " The appropriate authority is required by the legislation above to maintain a register which holds information provided in this form, which can be inspected online or in person by members ofthe public on request. It may also be required to release :Information, including personal data and commercial information, on request under the Environmental Information Regulations 2004 or the Freedom of Information Act 2000. However, the appropriate authority will not permit any unwarranted breach of confidentiality nor will they act in contravention oftheir obligations under the Data Protection Act 1998. I - Billingbcnr Houoc Fool Path11 Lnyout copyri~ht: Ilu11ctl 1111011 thc following Ortlmmcc Survey Scale 1:10,000 ~Amble Wutcr CUSTO~lAI' 1: 10,000 sculc digilul mupa current nt the LANFINE 13'ARMS LT]): ~ Quidhni1111, Quidhnm SI ~ ~ f\.~u1V' /fJlf